Adult Chronic Rhinosinusitis: Spectrum of Clinical features and management in a Tertiary Health Institution and Literature Review

Abstract

Background: Rhinosinusitis is defined as inflammation of the nasal and paranasal sinus mucosa. Chronic rhinosinusitis occurs when this inflammation and the symptoms persist for more than 3 months. The objective of this study was to evaluate the clinical features and management of adult chronic rhinosinusitis in a tertiary health institution and to review the literature for its current modalities of management. Methods: This is a 5-year retrospective study of all adult patients managed for clinically and radiologically diagnosed chronic rhinosinusitis at the study center. Their medical records were reviewed for essential data which included demographic data, clinical presentations, skin sensitivity test, radiologic reports and treatment offered. The data were collated and analyzed using simple descriptive statistics. Results: There were 228 patients, 97(42.54%) males and 131(57.46%) females with a male: female ratio of 1:1.35, age ranged between 18 - 67 years (mean =35.2). The five major presenting symptoms were nasal discharge 228(100.00%), nasal obstruction 224 (98.25%), frequent throat hawking 189 (82.89%), itching of eye, ear, nose or throat 138 (60.53%) and excessive sneezing 136(59.65%). About 6% of the patients developed complications. Allergy accounted for the cause in 93 (40.79%) patients. Maxillary antral mucosal thickening and engorged inferior turbinates were the commonest radiological features. About 51% of the patients were treated with intranasal inferior meatal antrostomy with or without inferior turbinectomy. There was recurrence of symptoms in about 18% of these patients from 3 to 8months after surgery. Conclusions: Both subjective and objective measures should be employed in the diagnosis of chronic rhinosinusitis and intranasal inferior meatal antrostomy may rarely produce satisfactory clinical improvement.